Innovation will have an important role to play in recovering from the aftermath of the coronavirus. Indeed, it is through innovation that the world has found its primary defence against the virus; vaccines. The lens of COVID-19 has brought into sharper focus both the complexity and unpredictability of managing innovation, particularly in healthcare. This article considers why today’s open, intrinsically unpredictable business environments demand a rethink of established, often binary, theories for managing innovation. The impact of Covid-19 on the healthcare sector has been enormous. It shifted consumer preferences, upset supply chains, prompted a radical rethink of clinical trial protocols, accelerated the adoption of digital tools and catalysed an explosion of investment in home and digital care.